a see oo gO 2B, . STATE OF FLORIDA AGE ENCY FOR HEALTH CARE ADMINISTRATION MS BAY -b Poi 5b STATE OF FLORIDA: cAGENCY FOR Petitioner, vs. AHCA No. 2001049941 EMERITUS PROPERTIES V, INC., d/b/a STANFORD CENTRE, INC., Respondent. FINAL ORDER Having reviewed the Amended Administrative Complaint in the above- styled case, dated December 6, 2004, and all other matters of record, the Agency for Health Care Administration (“Agency”) finds and concludes as follows: FINDINGS OF FACT 1. The Agency issued an Amended Administrative Complaint, dated December 6, 2004, against Respondent, stating the intent to impose a fine in the amount of FIVE THOUSAND DOLLARS ($5,000). (Exhibit A) 2. On December 28, 2004, the Agency received the Respondent’s request for a formal administrative hearing. (Exhibit B) 3. The formal administrative hearing in this case was scheduled to be held on March 16, 2005. (Exhibit C) DOAH No. 05-0047 pm \o- 4. On January 26, 2005, the Agency filed an Agreed Motion to Close File with the Division of Administrative Hearings, wherein the Agency moved the Court to enter an Order closing the file for the above-styled case. (Exhibit D) 5. On January 28, 2005, the Honorable Daniel M. Kilbride, Administrative Law Judge, issued an Order closing the file in this case with leave for either party to request the Division of Administrative Hearings to reopen the case, should the settlement be disapproved by Office of Licensuxve and Certification. (Exhibit E) Based on the foregoing, it is ORDERED and ADJUDGED: 1. The Amended Administrative Complaint, dated December 6, 2004, is hereby withdrawn; and no other action affecting the Respondent in this case is pending. 2. The request for a formal administrative hearing is dismissed; and the issue is moot. ~ DONE and ORDERED this<9/_ day of Chae) 2005 in Tallahassee, Leon County, Florida. pap th Pid Alan Levine, Secretary Agency foy Health Care Administration A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK AND A SECOND COPY, ALONG WITH FILING FEE AS PRESCRIBED BY LAW, IN THE DISTRICT COURT OF APPEAL WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW PROCEEDINGS SHALL BE CONDUCTION IN ACCORDANCE WITH THE FLORIDA APPELATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN THIRTY (30) DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies furnished to: Honorable Ann Cole, Clerk Florida Division of Administrative Hearings 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Theodore E. Mack, Esquire Counsel for Stanford Centre, Inc. POWELL & MACK 803 North Calhoun Street Tallahassee, Florida 32308 (U.S. Mail) (U. S. Mail) Jean Lombardi Finance & Accounting Agency for Health Care Elizabeth Dudek Deputy Secretary Agency for Health Care Adninistration Administration 2727 Mahan Drive Bldg #1 MS #9 2727 Mahan Drive MS #14 Tallahassee, FL 32308 Tallahassee, Florida 32308 (Interoffice Mail) (Interoffice Mail) Esq. Wendy Adams Tracie Wilks, Agency for Health Care Assistant General Counsel Agency for Health Care Administration Administration 2727 Mahan Drive MS 3 2727 Mahan Drive MS 3 Tallahassee, FL 32308 Tallahassee, FL 32308 (Interoffice Mail) (Interoffice Mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing was mailed to the above-named addressees on this Zee day of Sree , 2005. Richard Shoop, Ageficy Clerk Agency for Health Care Administration 2727 Mahan Drive, Bldg #3, MS #3 Tallahassee, Florida 32303 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, AHCA No. 2001049941 Vv. DOAH CASE No. 05-0047 EMERITUS PROPERTIES V, INC., d/b/a STANFORD CENTRE, INC. Respondent, a STIPULATION AND SETTLEMENT AGREEMENT Petitioner, Agency for Health Care Administration (hereinafter the "Agency"), and EMERITUS PROPERTIES V, INC., d/b/a STANFORD CENTRE (hereinafter "Respondent’), through their undersigned representatives, pursuant to Sec. 120.57(4), Florida Statutes, each individually, a "party", collectively as "parties," hereby enter into this Stipulation and Settlement Agreement ("Agreement") and agree as follows: WHEREAS, STANFORD CENTRE, operates an assisted living facility licensed pursuant to Chapter 400, Part Ill, Florida Statutes, and Chapter 58A-5, Florida Administrative Code; and WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over STANFORD CENTRE, pursuant to Chapter 400, Part Ill, Florida Statutes; and Chapter 58A-5, Florida Administrative Code; WHEREAS, the Agency served STANFORD CENTRE an Amended Administrative Complaint on December 11, 2004, notifying the party of its intent to impose an administrative fine for FIVE THOUSAND DOLLARS ($5,000), and; Page i of S rene te ould Sure meee Gommar LApm yee seu Tat WHEREAS, STANFORD CENTRE requested a formal administrative hearing in documentation received by the Agency on December 28, 2004; and WHEREAS, the parties have agreed that a fair, efficlent, and cost effective resolution of this dispute would avoid the expenditure of substantial sums to litigate the dispute; and WHEREAS, the parties have negotiated and agreed that the best Interest of all the parties will be served by a settlement of this proceeding; and NOW THEREFORE, in consideration of the mutual promises and recitals herein, the parties intending to be legally bound, agree as follows: 1. All recitals are true and correct and are expressly incorporated herein. 2. Both parties agree that the “whereas” clauses incorporated herein are binding findings of the partles. 3. Upon full execution of this Agreement, STANFORD CENTRE agrees to a withdrawal of Its Petition for Formal Administrative Hearing, agrees to waive compliance with the form of the Final Order (findings of fact and conclusions of law) to which it may be entitled including, but not limited to, an informal proceeding under Subsection 120.57(2), a formal proceeding under Subsection 120.57(1), appeals under Section 120.68, Florida Statutes; and declaratory and ail writs of relief In any court or quasi- court (DOAH) of competent Jurisdiction. Provided, however, that no agreement herein, shall be deemed a waiver by either party of Its right to judicial enforcement of this stipulation. 4, Upon full executlon of this Agreement, the Agency agrees to a withdrawal of its Amended Administrative Complaint In the instant case against STANFORD CENTRE, as the issues raised therein are moot. Page 2 of 5 peceived Tine cand). S:27PH bend. HD 1 USM TURTLE WALA TRA QUT eee TEST 6. Venue for any action brought to enforce the terms of this Agreement or the Final Order entered pursuant hereto shall lie in the Circuit Court in Leon County, Florida, 6. Upon full execution of this Agreement, the Agency shall enter a Final Order adopting and incorporating the terms of this Agreement and dismissing the above-styled case. 7. Each party shail bear its own costs and attorney fees. 8. This Agreement shall become effective on the date upon which it is fully executed by ail the parties. 9. STANFORD CENTRE for itself and for its related or resulting organizations, Its successors or transferees, attorneys, heirs, and executors or administrators, does hereby discharge the Agency for Health Care Administration, and its agents, representatives, and attorneys of and from all claims, demands, actions, causes of action, sults, damages. losses, and expenses, of any and every nature whatsoever, arising out of or in any way related to this matter and the Agency's actions, including, but not limited to, any claims that were or may be asserted In any federal or state court or administrative forum, including any claims arising out of this agreement, by or on behalf of STANFORD CENTRE or related facilities. 40, The Agency for Health Care Administration, does hereby discharge STANFORD CENTRE, and its agents, representatives, and attorneys of and from all claims, demands, actions, causes of actlon, suits, damages, losses, and expenses, of any and every natura whatsoever, arising out of or in any way related to this matter and the Agency's actions, including, but not limited to, any claims that were or may be assertad in any federal or state court or administrative forum, including any claims . Page 3 of 5 Yecsived Tine van.3}. 5:27PM age 70 your en. ip) ua suuem buck a my arising out of this agreement, by or on behalf of the Agency for Health Care Administration. 11. This Agreement Is binding upon ail parties herein and those Identified In the aforementioned paragraph nine (9) of this Agreement. 12. The undersigned have read and understand this Agreement and have authority to bind their respective principals to it. 43. | This Agreement contains the entire understandings and agreements of the parties. 44. This Agreement supercedes any prior oral or written agreements between the parties. 16, A facsimile signature contained herein shall be as valid and binding as an original signature thereof. THE REMAINDER OF THIS PAGE IS INTENTIONALLY BLANK Ln . . nan, Page 4 of 5 Pacelved Time Jang). :27Phi 3 46. | This Agreement may not be amended except In writing. Any attempted assignment of thls Agreement shall be void. The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement. Zk THEODORE E. MACK, ESQUIRE DIVISION OF COUNSEL FOR STANFORD CENTRE HEALTH QUALITY ASSURANCE POWELL AND MACK AGENCY FOR HEALTH CARE 803 NORTH CALHOUN STREET ADMINISTRATION TALLAHASSEE FL 32308 2727 MAHAN DR MAIL STOP 9 TALLAHASSEE, FL 32308 DATED: 4/ 300 © paren: 2 /15/ OS A ae VADA Ce GON AMm H. Robects et: Ng General Counsel AGENCY FOR Ce NCY COR HEALTH CARE ADMINISTRATION 2727 MAHAN DRIVE MAIL STOP 3 TALLAHASSEE, FL 32308 DATED: GLYLE Page 5 of 5 Resgived Time Jin.3l- S:27PN TOTAL P.@6

Docket for Case No: 05-000047